Com a finalidade de se comparar as propriedades mecânicas do ligamento da patela e do tendão calcâneo foram realizados ensaios de tração em material obtido de 25 cadáveres humanos. A idade dos doadores foi 58 ± 14 anos (33-85), sendo 19 (76%) masculinos e 6 (24%) femininos, 23 brancos (92%) e dois negros (8%). Os materiais foram testados em seus 10 mm centrais, com velocidade de aplicação de carga de 30 mm/min. Foi obtida a área de secção dos corpos de prova para que fossem estudadas as propriedades estruturais e materiais. Foram estudadas as seguintes variáveis: carga máxima (N), tensão(MPa), módulo de elasticidade (MPa), energia (Nm), alongamento absoluto (mm) e específico (%), limite de proporcionalidade (N), além da tensão (MPa) e alongamentos neste ponto. A análise estatística revelou que ambos possuem carga máxima, limite de proporcionalidade e tensão semelhantes (p>0,05). Nas outras variáveis ocorreu diferença significativa (p<0,05) com o tendão calcâneo apresentando valores maiores para energia e alongamento. O módulo de elasticidade, significativamente maior no ligamento da patela (p<0,05), foi a variável que melhor caracterizou a diferença do comportamento mecânico dos dois materiais.
To assess, through a systematic literature review, whether or not it is necessary to suspend antithrombotic medications (warfarin, aspirin, and clopidogrel) to perform elective wrist and hand surgeries. The search for articles was performed using a combination of keywords in the databases available, without scientific design constraints, being selected series with five or more surgeries; the selected articles were analyzed regarding serious (need for surgical treatment) and mild complications (without surgery). Seven articles were retrieved and analyzed; 410 wrist and hand surgeries were performed in patients on warfarin or aspirin and clopidogrel, with three serious complications (0.7%) and 38 mild (9.2%); 2023 surgeries were performed in patients without use of antithrombotics, with zero serious and 18 (0.8%) minor complications. Patients using warfarin or oral antiplatelet (aspirin, clopidogrel, and aspirin associated with clopidogrel) need not suspend the medication to undergo wrist and hand surgery.
RESUMOFios de sutura de náilon (0, 3-0 e 4-0), poliéster trançado (0, 3-0 e 4-0) e polipropileno (0, 3-0 e 4-0) de 7 marcas comercializadas no Brasil, foram submetidos a análise de diâmetro, comprimento, resistência do encastoamento, resistência à tração do fio sem nó e resistência à tração do fio com nó, segundo metodologia padronizada pela Associação Brasileira de Normas Técnicas (ABNT). Os resultados obtidos indicam que a maioria dos fios testados encontra-se dentro dos valores preconizados pela ABNT.Descritores: Resistência à tração; Material de sutura; Propriedades mecânicas; Dimensões. INTRODUÇÃOA qualidade dos materiais de implantes metálicos utilizados no tratamento cirúrgico das fraturas, como placas, parafusos e hastes intra-medulares é fundamental na obtenção da consolidação óssea e na reabilitação funcional do paciente. A qualidade dos fios de sutura empregados nas cirurgias apresenta a mesma importância. Em algumas cirurgias específicas, como tenorrafias, miorrafias, reparos ligamentares e reparos capsulares, a qualidade do fio de sutura é fator primordial na obtenção de bons resultados assim como as técnicas operatórias utilizadas. Cirurgiões preocupados especificamente no tratamento de lesões de tendões têm realizado estudos mecânicos com materiais de sutura mais comumente utilizados nessas operações (7,10) .A busca do fio de sutura ideal caminha junto com a história da cirurgia. Galeno, no século II a.C., iniciou o uso do categute em suturas e ligaduras. Joseph Lister, no século XIX d.C., confeccionava artesanalmente os seus fios cirúrgicos e realizou a desinfec-SUMMARY Surgical materials of monofilament nylon (0, 3-0 and 4-0), braided polyester (0, 3-0 and 4-0) and monofilament polypropylene (0, 3-0 and 4-0) of 7 trademarks commercialized in Brazil, was submitted to analysis of diameter, length, enchasement resistance, tensile strength of surgery materials knotted and unknotted, according to ABNT. The results show that most of surgical materials was inside of preconizing patterns of ABNT.
ObjectiveSynthetic adhesives are used by various medical specialties, especially in surgery; however, studies reporting their use in orthopedic practice are scarce. The aim of this study was to compare the results in using ethyl-2-cyanoacrylate or butyl-2-cyanoacrylate in the treatment of fractures in rats.MethodsThis was an experimental prospective controlled study in 90 rats, with humerus, femur, and tibia fractures, treated with ethyl-2-cyanoacrylate (SB group; n = 45) or butyl-2-cyanoacrylate (HA group; n = 45). Biomechanical and histomorphometric analyses were performed at three different moments (60, 120, and 180 days); besides a clinical study performed weekly by measurement of the animals body mass.ResultsNo differences were observed regarding body mass (p = 0.07). In both groups, there were no significant differences regarding maximum load (p = 0.6), yield point strength (p = 0.6), and stiffness coefficient (p = 0.4) of the femurs. The same was observed in tibias for maximum load (p = 0.4), yield point strength (p = 0.7), and stiffness coefficient (p = 0.6). The humerus from both groups had similar bone callus area (p = 0.66). In both groups, there were no statistical differences related to inflammatory cells (p = 0.4), osteoblasts (p = 0.2), and osteoclasts (p = 0.2).ConclusionEthyl-2-cyanoacrylate was more effective than butyl-2-cyanoacrylate in the treatment of fractures in rats.
Background Platelet-rich plasma (PRP) has been used to favor anterior cruciate ligament (ACL) healing after reconstruction surgeries. However, clinical data are still inconclusive and subjective about PRP. Thus, we propose a quantitative method to demonstrate that PRP produced morphological structure changes. Methods Thirty-four patients undergoing ACL reconstruction surgery were evaluated and divided into control group (sixteen patients) without PRP application and experiment group (eighteen patients) with intraoperative application of PRP. Magnetic resonance imaging (MRI) scans were performed 3 months after surgery. We used Matlab® and machine learning (ML) in Orange Canvas® to texture analysis (TA) features extraction. Experienced radiologists delimited the regions of interest (RoIs) in the T2-weighted images. Sixty-two texture parameters were extracted, including gray-level co-occurrence matrix and gray level run length. We used the algorithms logistic regression (LR), naive Bayes (NB), and stochastic gradient descent (SGD). Results The accuracy of the classification with NB, LR, and SGD was 83.3%, 75%, 75%, respectively. For the area under the curve, NB, LR, and SGD presented values of 91.7%, 94.4%, 75%, respectively. In clinical evaluations, the groups show similar responses in terms of improvement in pain and increase in the IKDC index (International Knee Documentation Committee) and Lysholm score indices differing only in the assessment of flexion, which presents a significant difference for the group treated with PRP. Conclusions Here, we demonstrated quantitatively that patients who received PRP presented texture changes when compared to the control group. Thus, our findings suggest that PRP interferes with morphological parameters of the ACL. Trial registration Protocol no. CAAE 56164316.6.0000.5411.
BackgroundPlatelet-Rich Plasma (PRP) has been used to favor Anterior Cruciate Ligament (ACL) healing after reconstruction surgeries. However, clinical data are still inconclusive and subjective about PRP. Thus, we propose a quantitative method to demonstrate that PRP produced morphological structures changes.MethodsThirty-four patients undergoing ACL reconstruction surgery were evaluated and divided into Control Group (sixteen patients) without PRP application and Experiment Group (eighteen patients) with intraoperative application of PRP. Magnetic Resonance Imaging (MRI) scans were performed three months after surgery. We used Matlab® and Machine Learning (ML) in Orange Canvas® to Texture Analysis (TA) features extraction. Experienced radiologists delimited the regions of interest (RoIs) in the T2-weighted images. 62 texture parameters were extracted, including Gray-Level Co-occurrence Matrix and Gray Level Run Length. We used the algorithms Logistic Regression (LR), Naive Bayes (NB) and Stochastic Gradient Descent (SGD).ResultsThe accuracy of the classification with NB, LR, and SGD was 83.3%, 75%, 75%, respectively. For the area under the curve: NB, LR, and SGD presented values of 91.7%, 94.4%, 75%, respectively. In clinical evaluations, the groups show similar responses in terms of improvement in pain and increase in the IKDC index (International Knee Documentation Committee) and Lysholm Score indices differing only in the assessment of flexion, which presents a significant difference for the group treated with PRP.ConclusionsHere, we demonstrated quantitatively that patients who received PRP presented texture changes when compared to the control group. Thus, our findings suggest that PRP interferes with morphological parameters of the ACL.Trial RegistrationProtocol no. CAAE 56164316.6.0000.5411.
<p><strong>Introducción</strong></p><p><strong></strong>En las cirugías de la región retropúbica, la sección o ruptura de la anastomosis puede causar graves hemorragias de difícil control. Nuestro objetivo fue verificar la presencia o no de anastomosis arterial o venosa entre los vasos ilíacos y obturadores en la región retropúbica.</p><p><strong>Materiales y Métodos</strong></p><p><strong></strong>Treinta cadáveres (14 hombres/16 mujeres; 60% de raza blanca y 40%, no blanca). Después de la disección, se verificó si había anastomosis y su distancia de la sínfisis púbica.</p><p><strong>Resultados</strong></p><p><strong></strong>El 13,3% no tenía comunicación y el 86,6% tenía algún tipo de anastomosis (p <0,01), la anastomosis venosa fue la más frecuente (p <0,05). La distancia promedio entre la anastomosis y la sínfisis púbica fue de 5,7 cm. Al comparar el sexo, la anastomosis y el lado, el 57% de los hombres presentaba anastomosis en ambos lados, y el 81% y 88% de las mujeres la tenían en el lado derecho e izquierdo, respectivamente (p <0,05). Cuando se comparó la presencia de anastomosis con el lado, el 70% estaba en el derecho y el 73%, en el izquierdo (p >0,05). El 72% de los blancos y el 67% de raza no blanca tenían anastomosis (p >0,05).</p><p><strong>Conclusiones</strong></p><p><strong></strong>La presencia de anastomosis es más frecuente que la ausencia y no existe diferencia significativa en cuanto al lado. Está localizada, en promedio, a 5,7 cm de la sínfisis púbica y la venosa es significativamente más frecuente. Es significativamente más frecuente en las mujeres. No hay diferencia estadística en cuanto a la presencia de anastomosis entre la raza blanca y no blanca.</p>
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